Summary: TRACING THE STORY OF THE GLOBAL STRUGGLE TO MAKE HIV/AIDS DRUGS MORE AFFORDABLE AND AVAILABLE, A HUMAN QUESTION RAISES KEY QUESTIONS OF WHETHER PRIVATE OWNERSHIP OF KNOWLEDGE CAN BE AT THE COSTS OF HUMAN LIFE?

DOCTOR YUSUF HAMIED describes the process of devising a product, an ANTI AIDS DRUG called TRIOMUNE.
J : What prompted you to bring down the prices for AIDS medicines?
H : Well, it goes back a long time. Cipla started manufacturing anti-AIDS drugs in 1991, with AZT at the time. We marketed it in '93. No sale. Even though we sold it at 1/6th the international price. At that time a single treatment was 2 dollars a day, 60 dollars a month. Nobody could afford that, even in India. 1993/4 – we stopped all our work on AIDS. Then what happened – I came across a report called the HAART Report, which said that a cocktail of drugs could retard the HIV immune system. So we restarted our work on anti-AIDS drugs way back in 1997. Then we had certain criteria for drugs. What should be the criteria to market a good cocktail? Criteria Number One – The drug should be safe, the drug should be affordable, the drug should be efficacious. Not the best, but efficacious. Then the manufacture of those drugs should be sustainable. So with those criteria, we devised a product called Triomune.
1/6th the international price
anti aids drug
azt
cipla
cocktail of drugs
criteria for drugs
doctor yusuf hamied
efficacious
haart report
retard the hiv immune system
triomune
cipla
drug pricing and affordability
international trade. hiv/cancer medicine
pharma companies

At that point in time, in the year 2000, we could only sell the Triomune, and offer it, at about 6 to 800 dollars a patient a year. At that time a similar cocktail was being offered by the multinational companies at about 12000 dollars per patient per year. Then you couldn't sell much. Then on the 26th of January, 2001, we had the Gujarat earthquake. And suddenly we all woke up here, and said, here is a disaster unknown disaster, like your earthquake just now in Indonesia. So we said, AIDS in India and the rest of the world is a known disaster, what are you going to do about it? I consulted some of our friends, like Jamie Love in America, Bill Haddad in America, and on the 6th of February, 2001, we announced that we would sell our Aids cocktail, that is Triomune, at below a dollar a day. And that's when the whole awareness of HIV and Aids spread all over the world. Dollar a day. ADAD – A dollar a day.
Talks about how the GUJARAT EARTHQUAKE woke him up to the growing HIV EPIDEMIC IN INDIA and began offering TRIOMUNE at ADAD- A DOLLAR A DAY.
adad- a dollar a day
aids cocktail
america
bill haddad
gujurat earthquake
hiv epidemic in india
hiv/aids
indonesia
jamie love
multinational companies
triomune

And since then, you know, it's history, what has happened. But you'll be interested to know that today, it's not a dollar a day, it's half a dollar a day. And the dollar has depreciated like mad. So even in India today, we are offering our Aids drugs at affordable prices. Mainly because I sincerely believe, and I'd like you to spread this out as much as possible, I sincerely believe that to be HIV positive is not a death sentence. It can be regarded as a chronic ailment. On many forums, I have said, and I repeat, and I'd like you to repeat it to your audience, that god forbid somebody told me that I'm HIV positive, or that I have stomach cancer, please believe me, I would prefer to be HIV positive, because I know I can control it.
Discusses the MANAGEABILITY OF HIV/AIDS with proper, AFFORDABLE DRUG TREATMENT. Today it is half a dollar a day for HIV MEDICINES.
affordable drug treatment
chronic ailment
dollar depreciation
hiv medicines
hiv positive
manageability of hiv/aids
stomach cancer

Discusses the MANAGEABILITY OF HIV/AIDS with proper, AFFORDABLE DRUG TREATMENT.
Whereas if I have cancer of the stomach, or liver cancer, or kidney cancer, I can't control it. So to me, to be HIV positive can be treated as a chronic ailment. Controllable. If the right medicines are there, it is totally controllable. And that is a very very important message I think I would like to convey to my countrymen in India, and also to people all over the world.
affordable drug treatment
kidney cancer
liver cancer
manageability of hiv/aids
stomach cancer

J : What happened when you slashed the prices? What was the reaction of the international community?
H : Why do you talk about pricing? Why don't you talk about availability? Because I think pricing is a very very delicate issue. Everybody talks about pricing. Pricing is not the issue. Because the people who need the medication can't even afford a dollar. So where are you giving it to them at 150 dollars a year. These are all…pricing…NGO's, governments, World Bank, Global Fund, they should buy it. And they should distribute anti-Aids drugs, totally free, to whoever needs it. In Europe it's free. The Italians get it free. In England they get it free, under the National Health…why not here?
Says that DRUG PRICING is not as significant as AVAILABILITY OF DRUGS because people who need medication cannot even afford A DOLLAR A DAY.
a dollar a day
availability of drugs
distribute anti-aids drugs
drug pricing
england
europe
global fund
government
international community
italy
national health
ngos
world bank

J : What do you think is the reason they are not available?
H : I think you have to go back, and understand the situation in India. You're a lady? Have you had a mammogram done? No. You're a man, gentleman. Have you ever had a PSA test for prostrate? No. The point is that some of the major diseases, in India in particular, are what I term silent killers. Like breast cancer in women. When it is detected… 95% of the women with breast cancer in India, it's not detected. It's detected too late. It's in the third stage. Prostate cancer in men – the same thing. So I classify HIV positive in the same category. It's a silent killer. Nobody gets tested. And unless you test, how do you know that you're HIV positive? You can go through life, leading a normal life, even if you are HIV positive. So the question is, are you going to make testing mandatory? Today it is optional. So the question is, people are not detected. I spoke to the leading Aids doctor in India, one of the leading Aids doctors, Dr Pujari. Tell me, Doctor, how many patients do you have? He said over 2000. Tell me, how many of these patients actually came to you primarily because of HIV? And he said none.
Talks about the SILENT DISEASES such as HIV/AIDS and how that is one of the reasons it is not talked about in INDIA.
breast cancer
doctor pujari
hiv/aids
india
leading aids doctor
mammogram
mandatory testing
prostrate cancer
psa test
silent diseases
silent killers

Talks about the connections between TB AND HIV/AIDS and the HIV/AIDS STIGMA IN INDIA.
They come because of the opportunistic diseases connected with HIV. That is, if you're immune system breaks down, you're more susceptible to other diseases. In India, one of the most prevalent diseases to which you're susceptible is TB. You know why TB for HIV cases? Because one in three Indians has got what is called latent TB. So if you're also HIV positive, the TB flares up. So it is indirectly, via the opportunistic diseases, that you find out that somebody has HIV. So what are you going to do to check whether a person is HIV positive or not? That is why it is not being treated as judiciously and as widely as I think it should be treated. I have made suggestions, but my suggestions are very radical. I have made suggestions – that anybody who goes into a hospital, and needs a blood test, should also be tested for HIV. But if the government is going to test for HIV, then the government should assure the person who is being tested, that god forbid you're HIV positive, the government will treat you free of charge. We do this in our own companies, that if a worker wants an HIV test voluntarily, the company will keep the information confidential, god forbid if he is positive. The company would counsel him, his job is not at stake, and the company would treat him and his family totally free. And yet nobody comes forward. So this stigma about HIV in India has to be broken. Has to be broken. I think what you should do is see the four advertisements that Cipla showed a few years ago. It's important, that it is no longer a death sentence, it's a chronic ailment.
blood test
cipla
free treatment
hiv/aids is a chronic ailment
hiv/aids stigma in india
immune system
latent tb
opportunistic diseases
prevalent disease
tb and hiv/aids
voluntary hiv test

Discusses that it requires a MULTISECTORAL conversation to deal with the problem of HIV/AIDS and not just the DRUG INDUSTRY.
J : How was this message of yours received?
H : You must understand that today in the world, there are about 40 million HIV positive. You must also understand that 8000 plus are dying everyday because of HIV and related illnesses. The problem is not just what Cipla can do. It's a much wider problem. We're a small company, we're not a major company. So I sincerely believe that the effort required is a team effort – the multinational companies, ourselves, the government, or governments of various countries, and it has to be a team effort. In 1960, or...sorry in the year 2000, we made an offer. That we would give free the technology to produce ARV drugs to any government in the third world wanting to produce their own. Now this is five years ago. Not one government has come forward. I don't understand why. I also give one bottle of a drug totally free. It is there, called Nevimune, which stops the transmission of HIV, mother to child. I give that totally free. Both in Indian and internationally. There are no takers. Why? I don't understand. I believe that every woman, pregnant woman, going into a hospital for delivery, has to be tested. And if, god forbid, the person is HIV positive, has to be treated. So that you give the offspring a chance. So unless you strengthen your laws, and not have everything voluntary…I can't see it happening. I mentioned the word mandatory testing, like for example, I would strongly suggest that any driving license, truck driving license, should be for a period of one year, and it must be accompanied with a blood report, HIV test report. Very simple. So this spread of HIV throughout the country via the truck drivers could at least be retarded a little. So there are many ways. We should all sit down and have a brainstorming session on what to do and what not to do.
40 million hiv positive
blood test
cipla
driving license
drug industry
free technology to produce arv drugs
government
hiv test report
hiv/aids
mandatory testing
mother to child hiv transmission
multinational companies
multisectoral
nevimune
truck drivers

Describes the DISEASE PATTERN IN INDIA and the importance of ACCESS TO MEDICINES AT AFFORDABLE PRICES.
J : Truck drivers don't even have access to basic health services. How do we tackle these issues?
H : I think India missed out about 30-40 years ago, when…and I again sincerely believe that what we missed out in India was a sincere effort towards family planning. We missed out. Today if you look at India, with a population of 1.2 billion, what is the disease pattern in India? Are you aware of the disease pattern in India? Could I give you some statistics? 80 million cardiac patients in India, 80 million mental health patients in India, 60 million diabetics in India, 50 million asthmatics, 50 million Hepatitis-B, one in three Indians has got latent TB. The World Bank has said that by about 2015, India is likely to have 35 million HIV positive out of the total world of 75 million. So if the world today has 30-40 million HIV, and 8000 are dying per day, internationally of HIV, can you imagine that by the year 2015, over 8000 Indians are going to die, per day, of HIV. What are we doing about it? I mean, it's all very well talking, and NACO saying something, and the government saying something, and the minister, Health Minister saying something. But I think it is important, for us lay people, also to consider the problem not only of HIV, but also the larger problem that has opened up, of access to medicines at affordable prices. I think that is the main issue. And unfortunately, on that theme, if you digress a little to what is happening now post 1-1-2005, with the Patent Amendment Act, it is going to be a disaster for India.
1-1-2005
35 million hiv positive
50 million asthmatics
50 million hepatitis b
60 million diabetics
80 million cardiac patients
80 million mental health patients
access to medicines at affordable prices
basic health services
disease pattern in india
family planning
health minister
latent tb
naco
patent amendment act
truck drivers

Discusses the HISTORICAL CONTEXT OF THE PATENT LAWS and the consequences of the 1970 PATENT ACT.
J : What do you feel about the amendment?
H : Well, you must go back in history. What happened in 1972? Why did we change our laws? To know the future, you must know the past. So what happened in 1972, because I was party to it at the time, was that India decided that the patent laws were national laws. There is no two countries that have identical laws. So you have patent laws to suit the needs of your country. What were India's main needs in 1970? Can you tell me? (J : Prices of drugs were very high…) Among the highest in the world. No, we were following at that time the patent laws of England of 1911. We didn't change, even in 1947 we didn't change. England changed in 1949. We didn't change. We were still…even after independence, I still believe, we were under economic dependence. So we didn't change until 1972, September 1972. What were India's needs, and this is what I fought for, and others like me fought for. We said there were two needs. Health, and food. And that on these two issues, India would not compromise. So we passed a patent bill saying that specifically in these two areas only, you cannot patent the product, you can only patent the process to make the product, and that too for a period of seven years. So that saw, post-1972 till now, the golden age of the Indian national sector pharmaceutical industry. Companies like ourselves that grew, and the multinationals went down. So from being a net importer of drugs, India today is a leading exporter of drugs, etc. Now what has happened by India joining WTO, etc – we are going back to the pre-1972 era. And again what's going to happen – the prices of drugs will certainly go up. You won't feel the impact in the next 1 or 2,3 years. But I am sure that by 2008/2009, you will see the major major impact of monopoly.
1970 patent act
high drug prices
historical context of the patent laws
indian national sector pharmaceutical industry
leading exporter of drugs
major impact of monopoly
net importer of drugs
patent laws of england
patent laws were national laws
september 1972
wto

Discusses being for rewarding innovators, but not with MONOPOLIES, but with FIXED ROYALTY ON NET SALES.
We have never ever been against patents. Please understand. We have been against monopoly. And I have said again and again, and I repeat to the government, and through you I'd like to repeat to the public as well, that India with a population of 1.2 billion, with a disease pattern that I showed you, gave you just earlier, we cannot afford a monopoly. So what I am saying – we have never been against patents. Somebody invents something, he has to be rewarded. Pay him a 4% royalty. I have no option to my selling price, paying the person who's invented something a 4% royalty. But I can't be stopped. For a population like this. Should India be denied the use of life-saving drugs just because the originator doesn't want to bring the drug to my country? So we have to have in the law a safeguard that will automatic license of right. Please listen to me very carefully. On payment of the royalty, fixed royalty on our net sales. But do not give a monopoly.
disease pattern
fixed royalty on net sales
license of right
life saving drugs
monopolies
patents

Defends the quality of the GENERIC DRUGS and describes the INTERNATIONAL REGULATORY AUTHORITIES standards.
J : You're accused of being copycats, and some say that quality of generic drugs is not good, and hence they shouldn't be allowed to market their products…
H : Companies like Cipla today have been inspected, physically inspected, by international regulatory authorities from all over the world. There is not a week passes, when 1 or 2 or 3 of our factories are not inspected. Right now, in 2 of our factories, we have a British government regulatory inspection going on. So we are thoroughly inspected, more than even the multinationals. Do you know, there's not one multinational company in India, with a factory in India, that is internationally approved? Not one. They're not interested, to export from here. But we are. So all our factories are world-standard factories. So the question doesn't arise. What happens when you…once you go generic internationally, you have to show bioequivalence, that your product is bioequivalent to the originator. No problem. We're doing that. All the time. So this is a fallacy. This is more what the multinationals use as PR. Don't, for god's sake, believe it. The public should not believe it.
bioequivalence
british government regulatory inspection
generic drugs
international regulatory authorities
internationally approved
multinationals
originator
world standard factories

Discusses the drugs that were taken of the WHO LIST and why.
J : Some drugs were taken off the WHO list
H : No. No. You must understand…that is a non-issue, because all of those drugs have been reinstated. The problem was not with the companies, but with external testing. The problem was WHO's problem. If you do not approve outside laboratories, what are called CRO's, that is Contract Research Organisations, to do testing, that's your problem. I get my drug tested outside, because I don't have those facilities. You should in advance check them. I've told them, please give me a list of laboratories approved by you, where I can get my drugs tested. They say, we have none. Arey bhai, why not? So I think the whole thing will fall in place. It's a very very subtle game played by the multinationals to discredit Indian companies. And I'm sorry to say, but if you want to discredit the multinational companies, you can pick up any American drug journal, and see the recalls. Such and such recalled, such and such recalled. In America this happens everyday. There are CRO's in America and Canada, whose licenses have been withdrawn. So it happens all the time. It's nothing, nothing fantastic or new on this. But I can assure you, and if you look around this room and you see the products, that we are manufacturing and exporting, our quality is on par with the best anywhere in the world.
american drug journal
approved laboratories
canada
contract research organizations
external testing
licenses
manufacturing and exporting
multinational companies
recalls
who list

Discusses the two different kinds of research that exists in this industry--CONCEPTUAL RESEARCH and ME TOO RESEARCH.
J : Is all this due to the success of Indian generic companies, and are they now being seen as competition by MNC's?
H : There are two things. You must understand what you mean by Indian generics companies. Who are the Indian generics companies? That again is a major, is not an issue. We are all trying to put India on the international map. But this is only in the generic area, not so much in the new chemical entity area. That's a big problem. The research angle is a very big issue. And one of the question that I think you should raise, which is very important, is what the multinationals raise, that we spend millions on R&D. But they don't. This is the whole question. Let me give you some examples of that. There are two types of research – conceptual research and me-too research. Now what do you mean by conceptual and me-too? This is very important. Conceptual research is – the first tranquiliser, Dizapam, concept. After that the other tranquilisers that have come to the market are me-too. Your major expense in R&D is conceptual R&D. The American government today spends 20 billion dollars a day with NIH, at the University levels. 20 billion dollars on conceptual R&D. What the drug industry does, essentially, is 90% of the effort is on me-too research. You have the first beta-blocker ___, then you bring out ___, ____, so that is all me-too. Very little expense is required in that. What is required, and what the multinationals spend on, is what is called evergreening. Have you heard the phrase "evergreening"?
american government
conceptual research
dizapam
drug research spending
evergreening
first beta blocker
first tranquiliser
indian generic companies
me too research
mnc
new chemical entity area
r and d

Describes EVERGREENING-- the process of getting PATENTS extending beyond 20 years through minor changes made to the drug.
Evergreening is a thing that…if a patent life is 20 years, and if the drug is a very good drug, how do I extend patent life? Can I give you a very good example in the Aids area? The Aids drug AZT, which you've heard of, was originally invented in 1963. In 1985, it was discovered that AZT can be used effectively in HIV. So they got out a patent in 1985 for 20 years, internationally, till 2005. So today, internationally, nobody can market or sell AZT except the guy who's got the rights to that patent – 2005. Then there's another drug called lamivudine – you've heard of lamivudine – now that was invented in 1987. That patent internationally expires in 2007. Ok? What does the patent holder say? In my opinion, AZT should not be given on its own. In my opinion, lamivudine should not be given on its own. It should be given in combination. It's not an invention, because Aids drugs are given in combination. So he puts the two drugs together, takes out a patent in 1997, which goes on till 2017. So here is a drug AZT, invented in 63, covered under patent, directly and indirectly, up to 2017. 54 years of monopoly. Is that what patenting is all about? So this is what is called evergreening. A little subtle change in the formula, or in the crystal structure, or in particle size, and you have another patent, and you go on and on and on. And I sincerely believe that we are now going to enter an age of litigations, because we will be in court all the time.
age of litigations
aids drugs
azt
combination
evergreening
lamivudine
monopoly
patent internationally expires
patents

J : Do you think we can afford these litigations?
H : No. But then it is up to the government to wake up, and protect India. And like I've said time and time again, patent laws are national laws, for the benefit of the country. And India should decide its own destiny. India's destiny should not be decide in the corridors of power in London and Washington.
Speaks about GOVERNMENT ACCOUNTABILITY.
corridors of power
destiny
government accountability
litigations
london
patent laws are national laws
washington

Discusses the need for a COMPULSORY LICENSING SYSTEM with a FIXED ROYALTY OF 4% instead of MONOPOLIES.
J : But this government…
H : I don't know who's influencing the government today. But I do believe that… I hope that better sense will prevail when the patent bill is introduced. And one of the major things that I would like to mention was on compulsory licensing. Like I've said earlier, I have nothing against patents. I'm against monopoly. So with the disease pattern that I've given you, what I sincerely believe, and recommend to the Indian government, that they should announce that health in India is a permanent crisis. Now if anybody, even you, don't agree with me after that statistics that I have shown you, I believe is anti-national. Health in India is a permanent crisis. If it is a permanent crisis, I want a permanent compulsory licensing system, which means that for any drug, I should have the automatic license of right, and pay a fixed royalty of 4%. You know, Canada had this rule from 1969 till 1992. So why can't we have the same rule for our country's interests? So on the issue of compulsory licensing, I am adamant. We need to have a permanent rule. The second question, which we are overlooking and which the government is overlooking, is what is called Least Developed Country. Are you familiar with what is a Least Developed Country. You are? Tell me.
canada
compulsory licensing system
disease pattern
fixed royalty of 4%
health in india
indian government
least developed country
monopolies
patent bill

Discusses why INDIA should have been listed under LEAST DEVELOPED COUNTRY, and therefore should not have had the PATENTABILITY applied to it.
J : …
H : No. WTO has not listed. At Doha, they listed 49 countries, that in their opinion were least developed. Why was India not listed? Why was India not listed (J : …) No, my dear lady, India was not listed because of arm-twisting. In my opinion, if you look at the UN Human Development Index for 2002-03, even if you go back to 1990, India ranks about 127th among all countries. In the HDI, even countries like Sri Lanka are well above India. So just because five or six centres in India are super-developed – Bangalore, Bombay, Hyderabad, Delhi, Madras, Calcutta – doesn't make India a developed country, I'm sorry to say. I mean, look at UP, look at Bihar, look at Orissa, you know, India's not a country, India's a continent. And 90% of India cannot be regarded as developed. Do you know, our countrymen…there are 300 million of our countrymen today who don't have a square meal in the day? And you're saying we're developed? How? So what I have said – we may be developed, but for the purposes of TRIPS, for the purposes of health, we are not developed, and we should have been regarded as LD C and patentability should not have been thrust on us in 2005; we should have been extended till 2016, like it has been extended to 49 countries worldwide. In fact, WTO does not have any guidelines for earmarking a country developed or underdeveloped.
bangalore
bihar
bombay
calcutta
delhi
guidelines
hdi
hyderabad
india
india ranks 127th
least developed country
madras
orissa
patentability
sri lanka
trips
un human development index
up
wto

Discusses that INDIA should be listed under LEAST DEVELOPED COUNTRIES even if WTO used TRADE as a criteria for DEVELOPMENT. Also discusses why being part of the WTO is not as beneficial as the INDIAN GOVERNMENT might say.
I had a thing to WTO, which I think very interesting to you, is what is the amount of international trade that India today has? Are you aware of the figure? India 3 years ago had 0.4% of the world's trade. And the Commerce Minister at that time – he died unfortunately, Maran – in parliament announced that India will achieve 1% in an other decade. So India as a country has today about maybe 0.5 to 0.6% of world trade. It is likely that by 2010, India may achieve 1%. So my contention to WTO is , that if you are a trade organisation, then trade should be the guideline for least developed or developed. And you can say that those countries with a world trade below 2% will be regarded as least developed, those between 2 and 5 will be regarded as semi-developed, and those above 5 will be regarded as super-developed. But if trade is a criteria - you're a trade organisation - trade should be the guideline. Now here India, with 0.5% of world trade, is introducing patents and this and that. For whose benefit? Even if we were not members of WTO, do you think it would make any difference to our lives? No. I've strongly suggested that India withdraw from WTO. It's not…with 0.5%…China, till last year or so, was not a member of WTO. Nobody…no Chinese trade suffered; they had bilateral agreements with all the countries. So I…I don't know what is the overall purpose of WTO for a country the size of India. The Americans couldn't care a damn. They're having bilateral agreements with China, preferred nation with Israel. Israeli goods coming into America – no duty, Indian goods coming into America – duty. That's against WTO. All countries should be treated equally, if you're a member of WTO. Then what about the agricultural subsidies, that Arun Jaitley raised at Cancun? Also a problem. So my contention is we have to study very very carefully what is best for our whole country. Today, tomorrow, and in the future. And if any Indian tells me, with a disease pattern that I have pointed out to you earlier, that health is not a permanent crisis in this country, to me is anti-national. And we have to do something more serious about access to medicines at affordable prices in the future.
access to medicines at affordable prices
agricultural subsidies
americans
arun jaitley
bilateral agreements
cancun
china
chinese trade
commerce minister
development
disease pattern
duty on trade goods
india
indian government
israel
least developed countries
maran
patents
trade
trade organization
wto

J : What was the WTO's response to your presentation?
H : I never presented anything to WTO. They won't listen to my presentations; they'll only listen to government to government. So I have no standing with WTO. As an individual, what standing do I have? Nothing. …What else would you like from me?
WTO only listens to GOVERNMENTS, not INDIVIDUAL PRESENTATIONS
governments
individual presentations
wto

Discusses MNCS claim that they do not make PROFITS.
J : Garnier says MNC's don't take profits…
H : My dear lady, the less said the better. I know Mr Garnier. I've met him once in my life. If he really meant what he said, then he should have started a humanitarian gesture, or a social objective, a long time ago, by offering HIV drugs at affordable prices. It was his drugs that were selling at 12,000 dollars per patient a year in Africa, not mine. So where does the question of profitability come in? again, I'm repeating again and again and again, for the benefit of we Indians, it is not patents, it's monopoly. Monopoly leads to high prices. Wherever there is competition, prices are down. Wherever there is monopoly, prices are high. Whether it refers to drugs or any other commodity or whatever. So my contention here is that we need a system in India for the population that we have, of no monopoly. And you tell Mr Garnier that 90% of the anti-Aids drugs that Glaxo markets – they never invented. They were all in-license products. So they never spent any money on the R&D. Zero. So when they say, our companies are spending millions on R&D, that's not true. If you look at the world's top 50 products, 70% of them which are being marketed today were not invented by the people marketing the products. They're all in-license products.
12000 dollars per patient per year
africa
anti aids drugs
garnier
glaxo
hiv drugs at affordable prices
in license products
invention
market
mncs
monopoly
patents
profits
r and d
social objective

Check names
Discusses the business playing field of MNCs and his own company, the kinds of money being spent on R AND D.
J : Can India afford that kind of research?
H : What is R&D? Please understand. I'll give you two examples. The entire so-called "R&D" by the private industry – that is, all industries, not only pharma, all industries – and public sector – that is defence, space, everything, CSIR labs, everything – the total cost last year was 3 billion dollars. Total. That is, India Inc., R&D, three billion dollars. Pfizer alone last year spent 7 billion dollars in R&D. If my company spends 10 million dollars a year on R&D – because I give my products at affordable prices in India as well – how can I compete with the likes of Pfizer? It is not a level playing field, my dear lady. I can't compete. How can I discover a new chemical entity and beat Pfizer? I just can't. A very interesting example I always cite is Italy. Italy till 1984 had a law like India. And the Italian local industry was top of the world. Exporting, this that. Lepate, Zamba, Carbo.___, ___, ____ big Italian companies. 20 years down the line, where are they? Those companies don't exist any more; they've been bought out by the big multinationals. From being a net exporter of drugs, Italy today is a net importer of drugs. Not one new drug has emanated from Italy. What are you talking about? See, a lot of what you hear on research, whether it is from CSIR laboratories or from people like Dr Anji Reddy, is all PR. What I do, in my company, and what I call R&D, I do accountable R&D, I do business R&D. That is, if I'm spending my money on R&D, I want to see the results tomorrow. Let me give you an example. What I mean by R&D. And correct me if I'm wrong. Let's take diabetes. There are today in India 60 million diabetics. Until recently, a drug like insulin was not manufactured in India. So to me, the manufacture of insulin in India is a new chemical entity. See, new chemical entity has to be region-based. I'm giving you my opinion. I'm not giving you international opinion, I'm giving you my opinion. So to me, somebody taking up the manufacture of insulin in India is doing something new for the country. In a village in India, Central India, if there's no electricity, there's no radio, there's no TV, so something…if it comes to that village, it's something new. So newness to me has to be regionalized.
anji reddy
carbo
csir labs
defence
diabetics
discusses the business playing field of <mncs
exporting
italian local industry
italy
lepate
manufacture of insulin
net exporter of drugs
net importer of drugs
new chemical entity
pfizer
public sector
r and d
space
zamba

Discusses CIPLA, its history and its principles.
Now for example, in my company Cipla, since 1972, I have introduced, or Cipla has introduced, not me, Cipla has introduced at least 20 to 40 drugs for the first time in India. They were known abroad, but not available in India. And that is the service that I believe a company like Cipla – humanitarian service – and social service, that we have done to the country over the last 30 to 40,50 years. By bringing drugs here to India which were previously not available. And in this context, let me tell you what happened in 1939. 4th of July, 1939. You have a photograph out there which I would like you to focus on, later, if you want, when Mahatma Gandhi visited this premises where you are sitting now. Why did he come here? Number one, he was a friend of my father. But he came here specifically to tell my father, I want you to assist in the war effort. Because what happened in 1939 when the war started? All drugs which we were importing from Germany, from Switzerland, from Europe, stopped. There was a vacuum. Who was going to produce those drugs? So at a very early stage in Cipla's history, we learnt the power of self-reliance and self-sufficiency. And that is what we did during the war years. And that philosophy of self-reliance and self-sufficiency has continued with the company even till today. In fact, that is one of my…two things - self-sufficiency, self-reliance, and access to medicines at affordable prices. I'm not saying cheap. Affordable prices.
access to medicines at affordable prices
cipla
cipla's history
europe
germany
humanitarian service
mahatma gandhi
switzerland
war effort

photo reference

J : What do you think will happen to pharma companies in India in the next few years?
H : Which companies? Specify. (J : ---) Specify. There are 25000 drug companies in India. When monopoly comes…and again you can take an example of Italy. Again, in Italy, what happened to the local Italian companies? What happened? Some of us, like Cipla…etcetera, will continue to survive, because our business is not India. Our business is overseas. And I'm a great believer – do as you would be done by – if you're coming into my country and monopolizing my country, I will do to you what you're doing to me. So I will go more and more outside, globally. Wherever I can. And market my products there. So today, if you look at Cipla this year, 2005, we are…40% of our turnover is export. Maybe next year it'll be 50%. Maybe by 2007, it'll be 60%. Who knows? But the emphasis will be that. Because in India, if they're going to monopolize us, then we will try and enter into the international market, international generic market, and live by the laws of the land. Say in the 49 countries where there are no patents till 2016. I can sell patented products there. Comfortably, till 2016. So it depends…we will still have to change our thinking. But we would lose out on the Indian market. We will certainly lose out on the Indian market, but we will not lose out on the international market. Some Indian companies have taken a lead, internationally, and we are trying to catch up on that. So I sincerely believe that those Indian companies, maybe half a dozen of them, maybe a dozen of them, that are likely to concentrate on exports, will survive. And those Indian companies who are essentially local, will have a very tough time. In the years to come. Immediate effect – nothing.
Talks about the future of PHARMA COMPANIES IN INDIA in terms of extending further into INTERNATIONAL GENERIC MARKETS.
cipla
indian market
international generic markets
italy
local italian companies
monopoly
no patents till 2016
pharma companies in india

Discusses the worst possible scenario with the effects of the PATENT BILL.
So the effect of the patent bill, if it is passed as such, the worst possible scenario, if you take, will be a domination by the multinationals in India post-2010. But litigations will start from next year. That is the worry. Litigation on some of the existing products that Indian companies are marketing. See, you are bringing in a law in 2005, and backdating it to 1-1-95, I can't understand why and how this being done, and for whose benefit this is being done. Not for India's benefit. And then you hear government people and the bureaucrats saying, oh but we have to fall in line with the international…they don't fall in line with us. So why should we fall in line with them? And for what? We owe it to our 1.2 billion people. And I am sorry to say, but it's a very sad situation, when national-minded Indians are not being heard.
domination of multinationals in india
litigations
patent bill

In fact you should see a statement…before India signed WTO, India formed a committee called the Gujral Committee, where IK Gujral, who later became Prime Minister – he was discussing whether India should join the WTO or not, and what should be the guidelines. You should see the recommendations of the Gujral Committee, and our current Prime Minister, Manmohan Singh, he gave evidence to that committee. And you should see what evidence he gave to that committee. I think, from the archives, you should find out. The Gujral Committee Recommendations of December 1993. I gave evidence to that committee. You should see my evidence. But you should see Manmohan Singh's evidence, where he clearly said that India has to look at its economic development for itself. So it's somehow very sad to see that we have been influenced by some of the multinational companies. And by educated Indians who are running these companies. I can't see, I can't see where their conscience…whether their conscience pricks or not. Because they're working for these companies. So they have to toe the company line. But in their heart of hearts…every time you see a multinational person, retiring from the multinational company, in India, Indian. How come he goes the other side? He does. No, I was paid to say this. Now you have retired, then you are now coming as a consultant to the Indian companies. I can name you quite a few in the pharmaceutical industry, who after retirement have come over to the so-called national sector. And said just the opposite of what they said when they were working for the multinational companies.
Talks about the THE GUJRAL COMMITTEE RECOMMENDATIONS OF DECEMBER 1993 that was formed before INDIA SIGNED WTO.
consultant
economic development
evidence to the committee
ik gujural
india signed wto
manmohan singh
multinational companies
national sector
pharmaceutical industry
prime minister
the gujral committee recommendations of december 1993

Criticizes the direction that INDIAN ECONOMY has taken, with benefits for just a few.
J : Is economic growth really going in the right direction?
H : No. No. Just because 1 or 2% of India's population is wealthy doesn't mean that there is economic growth all around. I would like to see whether it goes back, what percentage of Indians today are living below the poverty line, what percentage of Indians have a really tough life. I was in Bangalore last month. I couldn't travel. From the Taj Residency hotel to the airport took me one hour. So you know, it's a very sad and difficult life that people are living. My senior staff in my factory in Bangalore, which is just ten miles away from city centre, on the Old Madras Road. It takes them one and a half hours to reach work in the morning. Then for extended periods of time, cities like Delhi. I was last week in Poona. Six hours a day no electricity. What are we…in which direction is our country heading? And if anybody says that we're improving, and this and that…it may be selective, but I'm looking at the broader picture. That if 5% of India is improving, doesn't mean the country is improving. Tell me. I stand corrected. Tell me, how does the common man on the road…is his life any better today than it was 20 years ago. Tell me, I'll stand corrected. I'd like to know. But to me, no. 2-3% of the population, all right, with the tax structure the way it is, this that the other. Availability of goods. Malls are there, cars are there, ok, it's made life comfortable for those who can afford. But 95% of people cannot afford. Why should there be 80 million people with mental health problems? I think the problem is much more than what we make out.
That's it? More?
availability of goods
bangalore
delhi
indian economy
living below the poverty line
mental health
old madras road
poona
taj residency hotel
tax structure

J : Lots of different studies done on TRIPS Implementation.
H : I have said clearly…They are not international committees. People like NGO's talk, Oxfam makes statements, MSF makes statements, etc. Basically, what is it that is needed? You have to abide by the laws of the land. In India, you have to abide by Indian laws. I'm a great believer in that. So we Indians should make our own laws. The destiny of India should be in India's hands. So you make your laws to suit you. Essentially what you are saying is patents. Can I ask you a question? Define me a patent. What do you mean by a patent? Can I explain to you?
Talks about the STUDIES ON TRIPS IMPLEMENTATION and it's lack of INTERNATIONAL COMMITTEES.
indian laws
international committees
msf
ngo
oxfam
patents
studies on trips implementation

A patent is an invention by an inventor, but it is a grant of a favor by the State to the inventor. It is...the State says, India says, Jayashree, you've invented X. Here is a patent to you, a gift from the State to you. For a 20 year period, nobody can copy this gift. Ok? Now if it is a present given by the State to an individual or to the patent-holder, the State has the right to revoke it. The State has the right to revoke it, not the international community. So this is what I'm trying to say. That if I'm saying that for a particular disease a drug is there, but is not available in the country, or is very high-priced, the Indian government should say, this patent is revoked. But they cannot delay on that. So that is why I have been saying time and time again, give us the automatic license of right. Which is, whether TRIPS agrees or not, you bring it out. In 1972, when Indira Gandhi, in September '72, said there would be no patents, and she made a statement at WHO – no patenting of life and death. On medical discoveries, there should be no patenting of life and death. Come on. Because here in the pharma industry, as against other industries, obsolescence is very high. A drug marketed today, if a new drug comes which is better than the existing one, the existing one dies. In fact, companies like Cipla, 80% of our business today are of drugs that we didn't have 10 years ago. It's a process of evolution. Am I making it clear? So I'm a great believer that the Indian government should really sit together. Not the bureaucrats, the government, national-minded government. And what is in India's best interests, and if they say, this is a trade-off, then we are trading off the health of the country for other things like textile export. I think it is totally- totally incorrect, and a very insensitive statement to be made by the government. In health, and food, there is no trade-off. You have to be committed. Okay. Enough?
Discusses PATENTS further, its relevance in the DRUG INDUSTRY and TRIPS.
cipla
drug industry
drug marketing
indian government
indira gandhi statement at who
international community
invention
license of right
no patenting of life and death
no trade off
patents
state
textile export
trips